A retrospective: Lessons learned from eight years of conducting regulatory tobacco control policy campaigns in Los Angeles County

In 2004, the Los Angeles County (LAC) Tobacco Control and Prevention Program (TCPP) transitioned from a health education to a regulatory policy approach. TCPP's transformation required extensive organizational changes and capacity-building efforts that led to enacting substantially more tobacco control ordinances.

For example, based on coordinated efforts of TCPP and its community partners, a total of 126 tobacco control ordinances were enacted in 54 LAC cities and the unincorporated area between 2004 and 2012. These policies included 37 tobacco retailer licensing, 7 smoke-free multi-unit housing, 66 smoke-free outdoor areas (e.g., parks, beaches and dining) and 16 other types. By comparison, only 15 ordinances were enacted from 1998 to 2003.

Eight years of conducting field-based regulatory tobacco control policy campaigns in LAC provides a solid foundation for lessons learned. Among them: 1) intangibles such as commitment, passion, and tenacity are critical to achieving the goal of advancing local tobacco control policies; 2) a team approach is essential to achieving the policy successes; 3) creating and strengthening partnerships with organizations funded to provide technical assistance built TCPP's capacity; 4) use of highly structured campaign organizing tools (e.g., the PAIM, Midwest Academy Strategy Chart) coupled with technical support contributed to policy adoption; 5) and policy adoption readiness can be developed quickly, but benefits from highly structured processes, strong community partnerships, and robust technical assistance and capacity building infrastructure.

TCPP's successful transformation from health education toward a regulatory policy focus provides a model for other health departments and non-governmental organizations to follow.